Objective To reveal the role of serum ACE2/Ang (1-7)in the occurrence of atrial fibrillation (AF)and find new targets for the prevention and treatment of AF by analyzing the correlation between the serum concentration of ACE2/Ang (1-7 )in patients with rheumatic valvular heart disease and the occurrence of AF. Methods We collected the basic clinical information and peripheral venous blood of patients with rheumatic heart valve disease (totally 46 patients,including 24 with AF and 22 with SR).ELISA method was used to detect the serum concentration of ACE2,Ang (1-7)and AngⅡ in the serum samples.Then the differences and correlation between the two groups were analyzed.Results In the AF group ① the diameter of the left atrium was significantly greater than that in the SR group [(60.70±3.08 vs.48.15±2.16)mm,P<0.05];② the serum concentration of AngⅡ was significantly higher than that in the SR group [(45.88±2.87 vs.35.78±1.08)pg/mL, P<0.05],AngⅡ and left atrium diameter were positively correlated (Pearson test,P<0.05);③ the serum concentrations of ACE2 [(7.87±0.74 vs.11.65±0.57)U/L,P<0.05]and Ang (1-7)[(146.05±17.61 vs. 321.71±36.50)pg/mL,P<0.05]were significantly lower than those in the SR group,and negatively correlated with left atrium diameter (Pearson test,P<0.05);④ the serum concentration of Ang (1-7)was negatively correlated with AngⅡ concentration (Pearson test,P<0.05).Conclusion For patients with rheumatic valvular heart disease,ACE2/Ang (1-7 )may play a protective role in the occurrence of AF via antagonizing AngⅡ and inhibiting atrial remodeling.

Background:The evaluation system for predicting prognosis in patients with liver cirrhosis includes Child-Pugh,model for end-stage liver disease (MELD) and its derivative system,which provides important guiding value for evaluating the prognosis.However,its value still needs to be verified by further clinical studies.Aims:To investigate the predictive value of Child-Pugh,MELD,MELD-Na and iMELD score in assessing 3-month and 1-year survival rates in patients with hepatitis B cirrhosis.Methods:A total of 236 patients with hepatitis B cirrhosis from January 2012 to December 2016 at Fukang Hospital were enrolled.The 3-month and 1-year survival rates of patients with hepatitis B cirrhosis were determined,and Child-Pugh,MELD,MELD-Na and iMELD score were calculated.Area under ROC curve (AUC) was used to evaluate the accuracy of Child-Pugh,MELD,MELD-Na and iMELD score for predicting 3-month and 1-year survival rates.Results:Of the 236 patients with hepatitis B cirrhosis,43 died within 3 months,and 71 died within 1 year.The causes of death were upper gastrointestinal bleeding,hepatic encephalopathy,hepatorenal syndrome,spontaneous peritonitis and infection.Child-Pugh,MELD,MELD-Na and iMELD score in 3-months and 1-year survival group were significantly decreased than those in death group (P ＜ 0.05 or 0.01).AUC of Child-Pugh,MELD,MELD-Na and iMELD score for predicting 3-month survival were 0.791,0.818,0.853 and 0.897,respectively,and the difference among the four groups was significant (P ＜ 0.05).AUC of Child-Pugh,MELD,MELD-Na and iMELD score for predicting 1-year survival were 0.772,0.832,0.861 and 0.906,respectively,and the difference among the four groups was significant (P ＜ 0.05).The accuracy of Child-Pugh,MELD,MELD-Na and iMELD score for predicting 3-month and 1-year survival were 70.1％,79.8％,86.2％ and 89.3％,respectively.Conclusions:The accuracy of Child-Pugh,MELD,MELD-Na and iMELD score for assessing 3-month and 1-year survival rates of patients with hepatitis B cirrhosis is high,and is worthy to be applied in clinical practice.

Objective To compare vein valve function following pharmacomechanical thrombolysis (PMT) with simple catheter-directed thrombolysis (CDT) for deep vein thrombosis. Methods We retrospectively analyzed the clinical data of sixty patients who suffered acute lower extremity deep vein thrombsis in our hospital between October 2016 and March 2017. All patients underwent contralateral preprocedural duplex and bilateral postprocedure duplex to access patency and valve function. The patients were divided into three groups including a group A with catheter-directed thrombolysis (CDT) alone (36 patients with 20 males and 16 females at average age of 56 years), a group B with PMT alone (15 patients with 8 males and 7 females at average age of 55 years), and a group C with PMT combined CDT (9 patients with 4 males and 5 females at average age of 56 years). The valve function was compared among the Group A, Group B and Group C. Results There were 40.0% (24/60) patients with bilateral femoral vein valve reflux, 40.0% (24/60) patients with unilateral femoral vein valve reflux (all in the treated limbs), 20% (12/60) patients had no reflux in both limbs. Of the limbs treated with CDT alone, PMT alone and PMT combined CDT, the rate of valve reflux was 38.9% (14/36), 33.3% (5/15), and 55.6% (5/9) respectively (P=0.077). Conclusion In the patients suffering acute DVT, PMT or PMT combined CDT does not hamper valve function compared with CDT alone.